Summary & Overview
CPT 4155F: Clinical Measure or Encounter Element
CPT code 4155F is a CPT-coded clinical measure or encounter element for which no descriptive summary is available in the source input. Nationally, such CPT entries are used to document specific aspects of patient care, quality measurement, or encounter characteristics that inform billing, quality reporting, and clinical records. Understanding the presence and proper use of this code matters because accurate coding supports uniform documentation, enables consistent aggregation of clinical measures at scale, and affects claims processing and quality programs.
Key payers in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn what this code represents at a high level, the expected contexts of use derived from the CPT designation, and which major payers are typically relevant when considering coverage and claims handling. The publication outlines available benchmarks and policy considerations where present, highlights clinical context that informs when such a CPT entry might be applied, and notes gaps where input data is not available.
Data limitations: the input did not provide a detailed description, service type, typical site of service, associated modifiers, taxonomies, ICD-10 diagnoses, related codes, or service line. This summary focuses on the code's role as a CPT entry and the national significance of accurate clinical coding.
Billing Code Overview
CPT code 4155F has no formal summary on record. Based on the code designation, this entry represents a clinical measure or encounter element recorded using the CPT coding system. Service type: Data not available in the input. Typical site of service: Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an otolaryngology or head and neck surgery clinic with symptoms such as nasal obstruction, recurrent epistaxis, or a sinonasal mass identified on imaging. The clinician performs an endoscopic evaluation of the nasal cavity and paranasal sinuses, with directed biopsy or excision of suspicious tissue under local or general anesthesia. The workflow includes pre-procedure assessment, endoscopic visualization and instrumentation, tissue sampling with forceps or microdebrider, hemostasis, specimen submission to pathology, and post-procedure observation with discharge instructions. The procedure is commonly performed in an ambulatory surgical center or hospital outpatient department; sedation or monitored anesthesia care may be used depending on patient factors and procedure complexity.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure | Use when a distinct E/M visit is performed and documented on the same date as the procedure |
26 | Professional component | Use when reporting only the professional component of a service provided |